Provider Demographics
NPI:1134138209
Name:CANAWAY, BARBARAJEAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARAJEAN
Middle Name:
Last Name:CANAWAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4119
Mailing Address - Country:US
Mailing Address - Phone:585-227-0721
Mailing Address - Fax:585-227-8086
Practice Address - Street 1:1570 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4119
Practice Address - Country:US
Practice Address - Phone:585-227-0721
Practice Address - Fax:585-227-8086
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331725-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP019331725OtherRCIPA